| Organization Name: | OPTIMA HEALTH, PSC |
| NPI Number: | 1306127303 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CAROLYN SUE HARRIS (AUTHORIZED AGENT) |
| Mailing Address: | 138 Campbellsville Byp Suite 5 Campbellsville |
| State: | KY US |
| Postal Code: | 427188843 |
| Phone Number: | 2702834638 |
| Fax Number: | 2702834639 |
| NPI Enumeration Date: | 09/02/2011 |
| NPI Last Update Date: | 01/30/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QU0200X |
| License Number: | 03286 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | KY |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Urgent Care |
| Taxonomy Definition: | |